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Concept: Transtheoretical model


We examined the validity of ‘Transtheoretical Model of Behavior Change’ six stages in exercise domain. A paper-pencil survey was completed by 457 workers. Self-efficacy tended to increase from Precontemplation to Action, did not change from Action to Maintenance, and then increase from Maintenance to Termination. Pros tended to increase and cons decrease only from Precontemplation to Action. A follow-up survey was completed by 331 workers. More preparers (25.4%) moved to Action compared to precontemplator (3.8%) and contemplators (6.5%). Relapse rates were lower among those in Termination (17.0%) than those in Action (43.8%) and Maintenance (38.1%). These results partially supported the validity.

Concepts: Behavior, Logic, Transtheoretical model


Abstract Purpose. To determine whether Transtheoretical Model (TTM) constructs differ between individuals making successful versus unsuccessful stage transitions for consumption of five or more servings of fruit and vegetables each day and thus provide a useful basis for designing health promotion interventions. Design. Longitudinal, observational study. A randomly selected, multiethnic cohort of adults assessed at 6-month intervals over 2 years. Setting. General community, Hawaii. Subjects. There were 700 participants (62.6% female; mean = 47 ± 17.1 years; 31.1% Asian, 22.1% Native Hawaiian/Pacific Islander, 35.0% Caucasian; 25.1% participation rate). Measures. Stage of readiness, experiential and behavioral processes of change, pros, cons, self-efficacy, and self-reported fruit and vegetable consumption. Analysis. The study used t-tests to determine which TTM variable scores differed consistently between those making “successful” versus “unsuccessful ” stage transitions from precontemplation, preparation, and maintenance. Sample sizes for contemplation and action prohibited similar analyses. Results. Compared to those remaining in precontemplation, individuals successfully progressing from precontemplation showed significantly greater use of behavioral processes (collectively and self-liberation) and consciousness raising (p < .001). However, only self-liberation demonstrated significant differences consistently over time. Conclusion. This longitudinal investigation reveals that TTM behavioral processes, particularly self-liberation, predict successful transition out of precontemplation for adult fruit and vegetable consumption, suggesting that public health messages tailored according to these TTM variables may be effective for this group. However, for adults prepared to adopt or maintain fruit and vegetable consumption, tailoring based on variables from other theories is needed.

Concepts: Scientific method, Public health, Behavior, Fruit, Tomato, Vegetable, Vegetarian cuisine, Transtheoretical model


Objective Predictive and external validity was studied among cluster profiles for sun protection behavior within stages from Transtheoretical Model of behavior change using follow-up data. Methods Data from participants in a home-based expert system were analyzed. Longitudinal patterns of clusters on the precontemplation, contemplation, and preparation stages of change were assessed. Differences between clusters on membership in action/maintenance stages and scores on the Sun Protection Behavior Scale (SPBS) were measured at 12 and 24 months after intervention. Results Differences between clusters on stage progression and on scores from the SPBS were found at 12 and 24 months after intervention at all stages. Discussion Predictive and external validity of sun protection subtypes was established using sun protection variables after a stage-matched intervention. Results provide information to improve interventions for sun protection.

Concepts: Ultraviolet, Behavior, Transtheoretical model


BACKGROUND: We evaluated the effectiveness of a transtheoretical model (TTM)-based passive smoking prevention programme developed to enhance passive smoking avoidance among pregnant women and women with young children in Taiwan. Methods: Subjects were pregnant women recruited from the obstetrics/gynaecology department and women with children younger than age 3 recruited from the paediatrics department of four hospitals in Taiwan. Participants were randomly assigned to a group receiving a TTM-based intervention programme or a comparison group receiving routine care. The intervention programme consisted of educational materials and phone counselling. Baseline assessment and post-test data were collected from both groups using a self-reported questionnaire developed based on stages of change related to readiness for passive smoking avoidance. RESULTS: Determinants of change, post-test scores of knowledge, experiential and behavioural processes and self-efficacy were significantly different between the intervention group and comparison group among both pregnant women and mothers. Among pregnant women, the intervention group had significantly higher post-test scores than the comparison group. The distribution of percentages in three stages of change (Precontemplation, Contemplation/Preparation and Action/Maintenance) was significantly different between the two groups among both pregnant women and mothers. However, a higher percentage of mothers made progress in stages of change compared with pregnant women. Conclusion: A TTM-based intervention programme was potentially effective in passive smoking prevention by improving knowledge, experiential and behavioural processes and self-efficacy among pregnant women and women with young children. A higher percentage of mothers with young children had progressed in stages of change post-intervention compared with pregnant women.

Concepts: Public health, Smoking, Transtheoretical model


The current study used the transtheoretical model (TTM) as a guiding theoretical framework to assess differences in processes of change, decisional balance, and self-efficacy among deaf individuals with different levels of physical activity. Overall, 146 participants (M age = 26.4 yr, SD = 4.28) completed anonymous questionnaires assessing the dimensions of the TTM, stages of change, processes of change, decisional balance, and self-efficacy. Analysis of variance showed that both experiential and behavioral processes of change were higher in the preparation, action, and maintenance stages than in the other stages. Accordingly, the benefits of physical activity participation were stronger in the preparation stage, whereas the costs were more evident in the precontemplation stage. Finally, self-efficacy at the preparation stage was higher than in the other stages. The findings revealed how different stages of physical activity participation can be explained through the TTM, and the implications for physical activity intervention are discussed.

Concepts: Participation, Stage, Behavior, Analysis of variance, Live albums, 2007 albums, Debut albums, Transtheoretical model


The proliferation of health promotion apps along with mobile phones' array of features supporting health behavior change offers a new and innovative approach to childhood weight management. However, despite the critical role parents play in children’s weight related behaviors, few industry-led apps aimed at childhood weight management target parents. Furthermore, industry-led apps have been shown to lack a basis in behavior change theory and evidence. Equally important remains the issue of how to maximize users' engagement with mobile health (mHealth) interventions where there is growing consensus that inputs from the commercial app industry and the target population should be an integral part of the development process.

Concepts: Psychology, Health, Nutrition, The Target, Nursing, Behavior, Mobile phone, Transtheoretical model


Thousands of mobile health apps are now available for use on mobile phones for a variety of uses and conditions, including cancer survivorship. Many of these apps appear to deliver health behavior interventions but may fail to consider design considerations based in human computer interface and health behavior change theories.

Concepts: Vacuum tube, Object-oriented programming, Mobile phone, Interface, Rotary dial, Transtheoretical model, Push-button telephone


Social media offer a great opportunity to deliver smoking cessation treatment to young adults, but previous online and social media interventions targeting health behavior change have struggled with low participant engagement. We examined engagement generated by content based on the Transtheoretical Model of Behavior Change (TTM) in a motivationally tailored smoking cessation intervention on Facebook.

Concepts: Smoking cessation, Intervention, Transtheoretical model


Recent studies suggest social media may be an attractive strategy to promote mental health and wellness. There remains a need to examine the utility for individually tailored wellness messages posted to social media sites such as Facebook to facilitate positive psychological outcomes.

Concepts: Game theory, Psychology, Public health, Sociology, Mind, Behavior, Transtheoretical model, Social media


In today’s society, stress is more and more often a cause of disease. This makes stress management an important target of behavior change programs. Gamification has been suggested as one way to support health behavior change. However, it remains unclear to which extend available gamification techniques are integrated in stress management apps, and if their occurrence is linked to the use of elements from behavior change theory.

Concepts: Management, Stress, 2007 albums, Transtheoretical model